Midodrine B4 Sleep?

[mkoven]

My new cardiologist wants me to take another dose of midodrine at bedtime, thinking my chest pain is from autonomic swings in the middle of the night. Not much- just 5mgs. I did this last night, and slept pretty poorly. I remember it first made me jittery when I started on it almost a year ago, but no more dureing the day. It could also be a coincidence. Anyone else take it at night? (My supine bp isn't usually high on it).

[kitchmill]

I don't take it before bed, but have found that the few times that I've tried to take a nap not long after taking it, I wasn't able to fall asleep even though I was really tired. My blood pressure also doesn't go up much so I don't know what causes it.

[Ernie]

Hi,

I take 2,5 mg at bedtime and my daily dose is 7,5 mg.

[Sunfish]

i don't take intentional doses throughout the night &/or while sleeping, but b/c i'm so dependent on it being in my system any time that i'm awake i do often have it in my system during several hours of sleeping. if that's confusing, i'll try for a better/ clearer explanation: i take midodrine every 4-4.5 hours. without it i might as well be flat on the floor (which isn't to say that i'm not still that even with it, but that's another issue altogether... ). so let's say that it's 10pm & i'm not ready to go to sleep yet, that i still have to finish my medical to-do list for the night (IVs, dressing changes, etc), put my PJs on, brush my teeth, etc and my last dose of midodrine was at 5:30 such that i'm at the tail end of my 4.5hr maximum dosing window, i'll take another dose without second thought. all of my docs are fine with this & always have been, despite the fact that i might then be heading to sleep between 11 & 12, only an hour or two into what's at least a 4 hr dose. additionally, at times when i haven't even been able to sit up to use a bedside commode without having midodrine in my system, if i would wake up in the middle of the night having to use the toilet i would have to take a dose of midodrine & then wait 25-30 minutes for it to "kick in" before being able to go to the bathroom. so in those ways i have taken my midodrine at night &/or before/ during sleeping on many occasions. at times when my daily schedule has included a daily 2hr nap (or more) i've always taken my midodrine straight through as well. and i've been told to take &/or been given my midodrine before various procedures &/or operations where i would obviously be lying down &, albeit unnaturally, "sleeping" as well.

so, all in all i've used midodrine while sleeping in a wide variety of realms for many years and, all that said, i've never had any trouble doing so. i did have a few months this past year where my BP decided to be higher for a while but during that time we cut my midodrine altogether such that that's really unrelated to what you're asking here. for what you're asking here my answer is that i've never had any trouble with taking midodrine before/ during sleeping, lying flat, etc.

while it's not bad that you're paying attention to new medication changes, i would encourage you - short of a side effect that might be deemed dangerous - to not jump to any conclusions after only one night (much as you yourself mentioned re: it being the first night). unless last night's poor sleep included something drastic going on physically that you didn't mention in your post it seem that it would be reasonable to give it a few more nights before associating the poor sleep with the midodrine.

good luck (& better sleep!)

melissa

[mkoven]

thanks, you guys. I was so tired yesterday from lack of sleep, I took a slightly lower dose last night-3.75, and slept so-so. But still too early to say. I think I"m ovulating which always messes up my sleep, so that may be in there too.

One of the things that's hard is having to stay up to take the befopre bed dose, 4 hours after the earlier dose. So if I take my day time doses at 7, 11, 3, and 7, that means I have to stay up till 11 to take the bedtime dose, when I'd prefer to go to bed at 930/10. Maybe I just have to get up an hour earlier?

I"m just a little sick of how complicated night has become, with repeated bouts of chest pain, which there is still the thought might be prinzmetal, so not benign, my cpap. I"m now also sleeping in compression stockings to reduce the late night swings, and now the midodrine. I long for my younger days when I could just fall into bed and even look forward to it. Sleep has just become so complicated, and not in a good way.

The next step, if the night-time midodrine is to try cuttig back on florinef, since that is the only med that has been added since these chest pain episodes started, on the off chance I have too much fluid... And then, if that doesn't work, on to another calcium channel blocker, which it's hard to get excited about, as vasodilation sounds like a problematic idea at best.

[Sunfish]

i hear you 500% on missing the simpler days of just falling into bed. in fact i'm still jealous of your routine as it's light years simpler than mine (which by no mean is to say it doesn't still royally stink for you!) my mandatory before-bed medical routine is almost 2 hours long 6 days a week & 3-4 hrs the other day....filled with IVs, dressing changes, tube-related care, meds via my J tube, etc. believe it or not i have actually had dreams about the simple blessing of being able to take a pill by mouth. not being able to just fall into bed at the end of my day is one of the simple pleasures that i most miss, and one that i'm not likely to ever get back, with the possible exception of being able to eliminate some of my maintenance/ care routine if/when i move to a place of palliative/ hospice care someday & thus chuck some of my more aggressive interventions...but even then there will still be some things that have to be done for the mere sake of day-to-day living & comfort. i've tried to make the most of my forced evening routine by splurging on a nice TV/ DVD set-up in my room so that i can watch movies or TV while i'm going through the drudgery but that's little consolation at times. and more than once i have fallen asleep before or in the middle of my routine only to wake up in the middle of the night/ morning having to do what i can to do what needs to be done &, at times, falling miserably short wherein i pay dearly the next day. so yep...i definitely empathize with the desire (& inability) to hit the pillow at night without any consideration for med schedules or other assorted medical do-dads (of which i have WAY too large a collection surrounding my bed). for me it's one of those mixed blessings. i'm thankful to have the stuff b/c without it i wouldn't be here, but there are days/ hours/ moments when i am VERY tempted to chuck it all (or at least parts of it!) right out the window! ah well...

melissa

[flop]

My cardiologist prescribed my midodrine to be taken every 8 hours (ie 7am, 3pm, 11pm) (I know it seems crazy as it only lasts about 4 hours but that is how I was told to take it). The logic of the night-time dose was my frequent injuries from collapsing when getting up to go to the bathroom at night (used to be 3 or 4 bathroom visits every night).

I didn't notice any problems sleeping with midodrine in my system. I used to swallow the pills right before putting the light out.

It seems unproductive to have to stay up an extra 1-2 hours to take a pill, perhaps you should talk to your doctor or pharmacist about the schedule - maybe some of your earlier doses could go a bit close together or further apart to get the last dose nearer to bedtime. Some people can tell very clearly how long the midodrine stays in their system / can tell when it is wearing off, knowing that personal time interval may be helpful.

flop